Health Effects of Stress in the City

One study of metropolitan areas found that self-reported impatience increased young adults’ risk of developing high blood pressure, a major risk factor for heart and kidney disease. One potential mechanism is that impatience can lead to activation of the fight or flight system, or sympathetic nervous system, resulting in an increased heart rate, blood pressure, and a release of stress hormones like adrenaline, noradrenaline and cortisol into the bloodstream.

Small bursts of the sympathetic nervous system can be helpful by increasing energy and awareness and decreasing your sensitivity to pain. But if you are constantly turning on this stress system throughout the day and weeks, the prolonged and higher level of stress hormones wears down your body and mind. The chronic overactivation of this stress response can over time lead to higher blood pressure, lower immunity, decreased muscle tissue and bone density, as well as decreased cognitive performance. In short, you get worn down both physically and mentally.

Studies have suggested that city living is associated with increased rates of depression, anxiety, and psychosis, with 39% more mood disorders and 21% more anxiety disorders. The reasons for these potential urban-rural differences are complex and may depend on factors such as race, immigrant status, working status, and marital status. Do urban environments cause increased rates of psychological issues or is it a selection bias (i.e., people with these disorders are more likely to live in urban areas or have access health care?) One functional magnetic resonance imaging study in Nature examined the potential differences in neurological processing of the stress of urban living and found that city living was associated with increased amygdala activity, the part of the brain important in emotional learning and behavior.

The question of whether and why these urban-rural differences exist remains controversial. A recently published study in Journal of Psychiatric Research found no such urban-rural differences in the prevalence of depression or other mental disorders. Further studies are needed to examine if there are indeed urban-rural differences in psychological disorders, and, if so, the potential mechanisms behind these differences.

As urban populations grow, the issue of urbanization and mental health becomes increasingly relevant. More than half of the world’s population lives in urban areas. By 2050, two-thirds of the world's population is expected to live in cities. It is increasingly important to understand whether and how the city environment and our pace of life affect our physical and mental health. In the meantime, exploring our ability to prevent and stop the negative psychological effects of city life is equally, if not, more important.